Increase in Finan/Skinnerian Steps | nationalpsychologist

Articles: Increase in financial scams of older adults creates need for expert evaluators &
Skinnerian steps needed to increase successful COVID-reduction methods {Below}

Increase in financial scams of older adults creates need for expert evaluators

By Paula Hartman-Stein, Ph.D.

October 14, 2020

A year after his wife died, an 89- year-old man changed his will, leaving everything to his daughter and cutting his only son completely out of his will. The assets had previously been divided 60/40 in favor of the daughter. At age 92, the man paid to remodel his daughter’s house to make the first floor accessible before moving in with her. Additionally, he paid to update her basement rec room and for law school for her daughter.

During a visit with his son after his wife’s death, he became tearful while informing him he had made a decision he regretted but said it was too late to change because he was afraid to upset his daughter.

Two years later, the man died. At his funeral, the daughter held up the will in front of her brother, saying, “Go ahead and try and fight this.” The son did not seek legal advice but harbored longstanding feelings of hurt and resentment toward his sister.

After learning how much she owed on the mortgage for her 4,000-square-foot home, an 80-year-old recently widowed woman considered moving to a smaller home. But first, she hired a

contractor to fix the roof. He was friendly and charming, and she looked forward to his visits. He talked her into remodeling a bathroom and convinced her to stay in the home and take out a reverse mortgage. Knowing her bank account numbers and login, the contractor absconded with the $350,000 she received for the reverse mortgage.

These are not uncommon scenarios, according to Peter Lichtenberg, Ph.D., psychology professor and director of the Institute of Gerontology at Wayne State University.

From 2013 to 2017 there has been a 400 percent increase in the United States in suspicious financial activity with older adults. With 10,000 Americans turning 65 every day and billions of dollars in assets held by older Americans, the pursuit of these “nest eggs” is one of the fastest-growing consumer fraud issues, according to Lichtenberg’s website, OlderAdultNestEgg.com.

Nearly half of these crimes are committed by someone the older adult knows and trusts, such as a relative or caregiver.

In his address at the 2020 APA virtual convention in August, Lichtenberg said that while healthcare professionals are compelled to aid the vulnerable, they must also protect the rights of the capable.

“Both under and overprotection can be costly,” said Lichtenberg, winner of the 2019 M. Powell Lawton Award for Distinguished Contributions to Clinical Geropsychology.

He criticized evaluations of older adults that do not assess the individual’s ability to make financial decisions within the actual context of the person’s situation but instead rely on answers to hypothetical vignettes.

About 15 years ago, an attorney hired him to conduct an evaluation in a million-dollar

case of possible financial abuse. The attorney wanted to learn as much as possible

about dementia and offered to teach Lichtenberg how to be an expert evaluator in the

eyes of the courts. This case triggered his interest in the intersection of cognitive

decline, financial-capacity decision making and financial exploitation.

Lichtenberg found a lack of financial decision tools that focused on real-life situations, so

he developed his own. “Context matters when an older adult is making a choice about

financial issues,” he said.

His capacity evaluations include five steps: a cognitive evaluation; specific decisional ability applied to the financial question at hand; the level of the person’s awareness of deficits; evidence of undue influence; and integration of the information.

His website, launched in 2018, provides training modules and resources for healthcare professionals. It includes a 10-question Financial Decision Tracker (FDT) that provides a risk score of possible abuse useful for Adult Protective Service (APS) workers, elder law attorneys and financial investors and planners.

For mental health professionals well trained in administering standardized tests, Lichtenberg recommends using the FDT plus his 34-question Financial Vulnerability Assessment, an

in-depth interview to determine the factors involved in an older adult's financial decisions. A third component is a questionnaire, which asks a relative or friend about the older adult's recent financial decisions.

Stacey Wood, Ph.D., neuropsychologist, and professor of psychology at Scripps College in Claremont, Calif., uses the scales developed by Lichtenberg when evaluating the need for a guardian and when consulting on APS cases.

“Like most neuropsychologists when conducting a capacity evaluation, I use a cognitive battery,” Wood said. “But those of us in this area know that those tests are not always sensitive to the vulnerability of victims from undue influence. Peter’s tests evaluate areas that complement a traditional assessment and are helpful to have in court

because they are psychometrically sound and meet evidentiary requirements.”

Lichtenberg said during a phone interview that he has conducted several financial decision-making evaluations during the pandemic using telehealth administration.

“Assessment of physical and sexual abuse is more complicated, but financial capacity skills can be adequately evaluated through telehealth,” he said. “The idea that trust can only be

developed through in-person evaluations is mythical, not empirical.”

Psychologists can obtain the hour-long training in the use of his scales, which are electronically scored and recorded, at no charge. For more information, contact Lichtenberg at his e-mail, p.lichtenberg@wayne.edu.

Paula Hartman-Stein, Ph.D., is an independent consultant and trainer who has served on CMS expert workgroups for screening elder abuse and depression. She is co-editor of Enhancing Cognitive Fitness in Adults and is the Medicare correspondent for The National Psychologist.

Her e-mail is paula@centerforhealthyaging.com.

Her website is located at: centerforhealthyaging.com

Skinnerian steps needed to increase successful COVID-reduction methods

By Sharon R. Kahn, Ph.D

October 15, 2020

There appear to be few behavioral specialists involved in public-health contact tracing and other methods to control the pandemic who understand the basic Skinnerian principles of shaping behavioral change through consequences, either reinforcements or punishments.

But psychologists are uniquely positioned to advise politicians on this, particularly on how reinforcement increases desired behaviors.

Punishment doesn't always work for many reasons. First, it doesn't work when one is being punished for species-specific needs, such as those sketched out by Maslow in his pyramid of motivations. One of these is the need for a safe home base.

Millions of people have lost their jobs in the past quarter, threatening their ability to have a home. Prior to that, 10 percent of New York City public school children were homeless.

Even for those who still have homes, the need for love and belongingness may be missing. Zoom parties do not offer skin-to-skin contact or offer treatment for problems of ordinary life.

Punishing for such losses is puritanism at its worst because meting out punishment only serves to alienate people further from the punishers. It foments rebellion when normal wants,

desires and needs are expressed and then shamed or punished.

People who have always led comfortable lives are now finding that the most basic aspects of their

lives — safe sanitation and secure access to food --cannot be accessed. Anxiety and depression rise in a world where there are increased expectations, reduced means and no guidance or resources.

Second, punishing people with anger doesn’t work. Angry leaders just model anger; they don’t offer solutions. Anger is just as contagious as COVID-19 and just as destructive to healthy

human functioning. Anger leads to punishments, where everyone acts as a punisher, doing such things as posting photographs on social media showing violations of social distancing and

masks. Others tag them as if they were hurling rotten produce at someone in a bygone stockade.

Worse, some people intentionally violate social distancing to punish others, such as one woman who pepper-sprayed another who stood too close to her.

Other punishments, such as fining those who refuse to cooperate with contact tracing, are sure to backfire. Expect lawsuits by the ACLU. In Israel, few people pay such fines.

Furthermore, expect people to claim they are being confused with someone else. For

example, my own name, Sharon Kahn, is shared with several women in Manhattan.

One other Sharon Kahn and I shop at various online sites and I at times received e-mails

confirming her purchases. She probably receives mine at times. AnotherSharon Kahn

and I once shared a gynecologist. But only once, because at my first visit, the

gynecologist said: “Well, the last time you were here, it was for . . . ” I told him I had

never been there. And after that visit, I never was again.

Anger is energizing but absent of action it only increases the death toll. Take away the rhetoric and you hear nothing but the sound of websites crashing. Instead of punishment and anger, politicians need to immediately provide for the biological and safety needs of the population.

The actions that should be stressed should be based on harm reduction.

In England, for example, social distancing has been reduced to one meter (about one yard). Small changes such as this toward a larger goal are easier to reinforce and inspire a feeling of success. Furthermore, in the medical literature, English journals noted that social distancing is rarely successful - handwashing and improved hygiene do better.

And instead of shaming people who refuse to wear masks in public places, free masks could be offered at the entrance. Smiling greeters could reinforce this with words such as, “You’re never fully dressed without your mask.”

Harm-reduction measures are easier to put into action. Rewards can be easily offered. People want to feel like the things they do make a difference. Reward people for the smallest steps to

public safety.

People become depressed and anxious when they feel helpless and hopeless. Giving people a small, yet doable task increases morale. Cooperation increases when people feel what they do is valued by society.

Instead of scary, angry politicians sucking all the air out of their daily, televised news conferences, have them encourage literacy. Imagine public officials reading a chapter from a Harry Potter book each day, a story about a boy whom each year goes to school where someone tries to kill him. Still, for him, it is better than staying at home.

Sharon R. Kahn, Ph.D., is a psychologist based in New York City. She aspires to inspire via modeling positivity in her blog, her website and her teachings. She may be reached by email atdrsrkahn@gmail.com